PHARMACOTHERAPY IN ALZHEIMERS DEMENTIA - TREATMENT OF COGNITIVE SYMPTOMS - RESULTS OF NEW STUDIES

Recent investigations have given new insights into pathogenetical dete rminants of Alzheimer's disease. Amyloid deposition and neurofibrillar y tangles are no longer considered to be primary pathological changes. Neurobiological research tries to work out the etiopathogenital casca de that finally causes Alzheimer's disease. So far, several relevant p athogenetical factors have been detected, e. g. pertubated control of glucose breakdown, impairment of oxidative metabolism, impaired neurop rotection due to increased oxidative stress and non-enzymatic protein glycation as well as immunological disturbances. Thus, new strategies for the development of cognition-enhancing drugs are emerging. The aut hors review reports on agents, that are under investigation for the tr eatment of cognitive symptomatology in Alzheimer's disease. Some of th ese agents have already been used for treatment of other medical condi tions, e. g. nimodipine, memantine as well as selegiline. Many of them are still experimental. Promosing strategies include antioxidative ag ents (e. g. vitamin E, vitamin C, beta-carotin), acetylcholinesterase- inhibitors with central selectivity (e.g. ENA 713), M1- and M4-muscari nic receptor agonists (milameline) as well as sabeluzole, a benzothazi de derivative that shows neurotrophic activities and anti-inflammatory substances like indomethacin.